Care Home: Tanglewood, St Austell

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What the care home does well The people who use the service seem and/ or said they are happy with the care and support they receive. On the day of the inspection the people using the service, who we met looked well looked after, clean and well dressed. All of the people in the home had activities arranged for example two people were attending a Shiatsu session, and one person was going horse riding, and then going swimming. The house was clean and there was satisfactory numbers of staff members on duty. What the care home could do better: We also looked at evidence regarding requirements issued at the last inspection. Further improvement needs to occur in the following areas: * Staff need to receive basic Makaton training. One person who uses the service, uses this signing system regularly as a main form of communication. Of the three staff files assessed two staff have received this training in 2004 and 2006. It is important that all staff either attend a basic external course in this matter, or a core group of staff attend such training and then cascade this knowledge and skill to other staff-particularly new recruits.* The monies belonging to one person were checked, these were accurate and receipts had been obtained for expenditure. However, monies and valuables storage is not satisfactory. Although monies are stored in locked tins, the cupboard where monies are stored is not lockable. * Staff Training. Some training has been completed, however there are still some gaps in training required by regulation. Further training required by law for example regarding infection control, first aid, fire awareness, moving and handling, and food hygiene needs to be provided as necessary. * There have been several changes in the manager of the home since the last key inspection. A new manager-Gemma Richards- has just started at the home. We require an application, for her registration, to be submitted within three months of the date of this inspection. * The policies and procedures of the home are dated 2003. We understand the registered provider is in the process of reviewing its policies. This review needs to be completed and new policies issued to the staff group. * The registered provider has ensured a test was completed for the legionella bacteria through a specialist company. However there is no risk assessment regarding the prevention of legionnaire`s` disease, and no clear policy or records regarding what other action is taken to minimise this risk. * The building was generally well maintained and was clean. However the kitchen units do need replacement (i.e. at least the cupboard and drawer fronts) as some handles are missing. The kitchen floor covering, and the carpet in the lounge also need to be replaced as these are stained. * One person using the service, who we have shared some concerns about with the provider in the past, seems well cared for. Behavioural support services have been provided to the staff group from the registered provider. The new manager seems to have a good grounding in behavioural support. Some plans to extend the building have been drawn up, and the possibility that this person may have a `flat let` within the home are being considered. However it is not clear if and when these plans will be introduced. Negotiations are occurring with the person`s local authority about funding the plans. In the past there were concerns regarding the person`s behaviour particularly towards other people using the service, although these altercations now appear to be minimal. At the very least the registered provider needs to ensure the person is well supported, and should there be further altercations between this person, and others suitable action needs to take place so others are not at risk. Should this occur the sponsoring authority needs to be informed of incidents and these incidents need to be reported to CQC-as required by the regulations. Random inspection report Care homes for adults (18-65 years) Name: Address: Tanglewood, St Austell Coombe Road Lanjeth, High Street St Austell Cornwall PL26 7TL two star good service 17/02/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Ian Wright Date: 2 4 0 3 2 0 1 0 Information about the care home Name of care home: Address: Tanglewood, St Austell Coombe Road Lanjeth, High Street St Austell Cornwall PL26 7TL 0172671088 Telephone number: Fax number: Email address: Provider web address: mail@dcact.org Name of registered provider(s): Name of registered manager (if applicable) Spectrum Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 3 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: Date of last inspection Brief description of the care home 3 1 7 0 2 2 0 0 9 Tanglewood is a detached bungalow in the village of Lanjeth, near St Austell. The home provides accommodation and care for up to three people with autism or Aspergers Syndrome. The registered provider is Spectrum, an organisation which provides specialist services for people with autism or Aspergers Syndrome. The registered managers post is vacant The accommodation consists of three single bedrooms, a large lounge, separate dining room, kitchen, bathroom and an activity room. The front access has two sets of two steps. There is a rear access with one step. The lounge is accessed via two fairly deep steps. There is a large garden with a patio, lawn and fishpond at the back and car parking space at the front. The office provides Care Homes for Adults (18-65 years) Page 2 of 11 Brief description of the care home the staff sleeping-in room. The home has vehicles to assist transportation in the community. The fees as given at the time of the last key inspection on 17th February 2009 were from £908.74 per week. Fees are based on an assessment of individual needs. A copy of the last inspection report is available via the registered provider. A copy of the report is also available free of charge via the CQC website at www.cqc.org.uk, or as a hard copy via our customer contact centre. CQC contact details are outlined at the back of this report. Care Homes for Adults (18-65 years) Page 3 of 11 What we found: This unannounced random inspection was completed to: * Ascertain management arrangements at the home comply with the Care Standards Act 2000, and associated regulations. * Check requirements issued at the key inspection on 17th February 2009 have been complied with. * Check care arrangements regarding one person which we previously had some concerns about. The methodology to complete this inspection was as follows: * We spoke to some people using the service to ask them their views about the home, and observed care practice. * We spoke to some staff and the manager about care practice and their experiences working in the home. * We inspected documentation. Generally we were satisfied with practice at the home. However we are concerned that insufficient action has occurred regarding the statutory requirements which were issued at the last key inspection. We must note that if this was a key inspection, this non compliance would result in us not being able to reward the service with its current rating. What the care home does well: What they could do better: We also looked at evidence regarding requirements issued at the last inspection. Further improvement needs to occur in the following areas: * Staff need to receive basic Makaton training. One person who uses the service, uses this signing system regularly as a main form of communication. Of the three staff files assessed two staff have received this training in 2004 and 2006. It is important that all staff either attend a basic external course in this matter, or a core group of staff attend such training and then cascade this knowledge and skill to other staff-particularly new recruits. Care Homes for Adults (18-65 years) Page 4 of 11 * The monies belonging to one person were checked, these were accurate and receipts had been obtained for expenditure. However, monies and valuables storage is not satisfactory. Although monies are stored in locked tins, the cupboard where monies are stored is not lockable. * Staff Training. Some training has been completed, however there are still some gaps in training required by regulation. Further training required by law for example regarding infection control, first aid, fire awareness, moving and handling, and food hygiene needs to be provided as necessary. * There have been several changes in the manager of the home since the last key inspection. A new manager-Gemma Richards- has just started at the home. We require an application, for her registration, to be submitted within three months of the date of this inspection. * The policies and procedures of the home are dated 2003. We understand the registered provider is in the process of reviewing its policies. This review needs to be completed and new policies issued to the staff group. * The registered provider has ensured a test was completed for the legionella bacteria through a specialist company. However there is no risk assessment regarding the prevention of legionnaires disease, and no clear policy or records regarding what other action is taken to minimise this risk. * The building was generally well maintained and was clean. However the kitchen units do need replacement (i.e. at least the cupboard and drawer fronts) as some handles are missing. The kitchen floor covering, and the carpet in the lounge also need to be replaced as these are stained. * One person using the service, who we have shared some concerns about with the provider in the past, seems well cared for. Behavioural support services have been provided to the staff group from the registered provider. The new manager seems to have a good grounding in behavioural support. Some plans to extend the building have been drawn up, and the possibility that this person may have a flat let within the home are being considered. However it is not clear if and when these plans will be introduced. Negotiations are occurring with the persons local authority about funding the plans. In the past there were concerns regarding the persons behaviour particularly towards other people using the service, although these altercations now appear to be minimal. At the very least the registered provider needs to ensure the person is well supported, and should there be further altercations between this person, and others suitable action needs to take place so others are not at risk. Should this occur the sponsoring authority needs to be informed of incidents and these incidents need to be reported to CQC-as required by the regulations. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Adults (18-65 years) Page 5 of 11 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 3 18 The registered provider needs to ensure all staff are formally trained to use the Makaton signing system. This will ensure people using the service can improve communication with staff who work with them 01/06/2009 2 9 16 There must be a secure place 01/04/2009 where money and valuables of people using the service can be deposited for safe keeping. This will ensure these items are kept more securely. 3 35 18 Staff need to receive training 01/06/2009 as outlined in the body of the report. This will ensure all staff have appropriate knowledge and skills, in accordance with the law and to meet the needs of the people accommodated in the home. 4 37 8 Submit an application for the 01/04/2009 manager to be registered with the Commission for Social Care Inspection. This will ensure the manager Care Homes for Adults (18-65 years) Page 6 of 11 Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action is deemed as fit by the commission to manage the home. 5 40 12 Update policies and procedures in the home, ensure staff are aware of these and they are available for inspection This will help to ensure staff are fully aware of the policies they need to work to. 6 42 12 Ensure a risk assessment is 01/04/2009 completed, and any subsequent control measures are introduced regarding the prevention of legionella. This should help to ensure staff and people who use the service are protected from this disease 01/04/2009 Care Homes for Adults (18-65 years) Page 7 of 11 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 3 18 The registered provider 01/08/2010 needs to ensure all staff are formally trained to use the Makaton signing system. (Previous deadline of 01/06/2009 not met-Second Notification) This will ensure people using the service can improve communication with staff who work with them 2 9 16 There must be a secure place 01/08/2010 where money and valuables of people using the service can be deposited for safe keeping. (Timescale of 01/04/2009 not met-Second Notification) This will ensure there items are kept more securely 3 19 16 Replace kitchen units, and 01/08/2010 floor coverings-as outlined in the report This will ensure the building is more pleasantly decorated Care Homes for Adults (18-65 years) Page 8 of 11 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 4 35 18 Staff need to receive training 01/08/2010 as outlined in the body of the report (Timescale of 01/06/2009 not met-Second Notification) This will ensure all staff have appropriate knowledge and skills, in accordance with the law and to meet the needs of the people accommodated in the home. 5 37 8 Submit an application for the 01/07/2010 manager to be registered with the Care Quality Commission. (Timescale of 01/04/2009 not met-Second Notification) This will ensure the manager is deemed as fit, by the commission, to manage the home. 6 40 12 Update policies and 01/08/2010 procedures in the home, ensure staff are aware of these and they are available for inspection. (Timescale of 01/04/2009 not met-Second Notification) This will help to ensure staff are fully aware of the policies they need to work to. 7 42 12 Ensure a risk assessment is 01/08/2010 completed, and any subsequent control measures are introduced regarding the prevention of legionella. (Timescale of 01/04/2009 not met- Second Notification) Page 9 of 11 Care Homes for Adults (18-65 years) Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action This should help to ensure staff and people who use the service are protected from this risk Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Adults (18-65 years) Page 11 of 11 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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